You are mentioning 2 facial aging issues. Let’s address them separately as to avoid confusion.
1. Saggy jowls - these are descent of the superior and inferior jowl fat pads coupled with skin laxity, laxity of the maxillary and zygomatic retaining ligaments and loss of volume of the deep fat pads of the mid face (Sub-Orbicularis Oculi Fat pad, Deep Medial Cheek Fat pad).
Suggested treatment: If the jowls are not too big, a combination of Ellanse in the SOOF, DMCF and maxillary and zygomatic ligaments to volumise and lift the midface support, and Korean strong molding threads / Silhouette Soft will be able to address at least 50-60% of the jowling at the first session.
A second session of threadlift may be needed 1 year later to further augment the results (Ellanse is not needed again as I prefer the E formulation of Ellanse that can last up to 4 years).
2. Loose wrinkled skin under your chin - this is likely a dermal and subcutaneous aging issue. The outer layer of skin loses collagen and elastin, and becomes loose and wrinkled with deep lines formed. The prominence of double chin fat exacerbates the issue.
Suggested treatment: First, ultherapy will be necessary to tighten and firm the neck muscle (platysma) and fats.
Then a Korean threadlift (with long barbs) or Silhouette Soft needs to be applied to physically cause contraction and tightening of the skin and soft tissues.
Lastly, a combination of Rejuran and Teosyal Redensity I are utilized to be injected intradermally into the problem areas, once a month for 4 times, for the best results. For deep neck horizontal lines, I am able to also use Ellanse with careful small injections to recreate the volume loss in the deep wrinkles as well.
The alternative to these, is surgical correction as Dr Samuel Ho expertly pointed out .
Hope this helps!
